US20040167428A1 - Biopsy device with inner cutting member - Google Patents

Abstract

The invention is directed to devices and methods for separating and collecting a tissue specimen from a patient's target site. The device includes a probe member with a penetrating distal tip and a tissue receiving aperture, and a tissue cutting member which is rotatable disposed within the probe member to cut a tissue specimen drawn into the interior of the device through the aperture. The longitudinal edges of the aperture are preferably sharpened to engage the cutting edges of the tissue cutting member. Vacuum may be provided in the inner lumen of the cutting member to transport tissue therethrough. Rotation, rotational oscillation and/or longitudinal reciprocation of the tissue cutting member is effective to separate a tissue specimen from surrounding tissue. An accessing cannula having an tissue receiving aperture may be concentrically disposed within the probe member and about the tissue cutting member. The tissue cutting edge of the tissue cutting member preferably is longitudinally oriented and may have a cutting angle less than 90° with respect to the longitudinal axis of the tissue cutting member.

Description

RELATED APPLICATIONS
• This application is a continuation-in-part of co-pending application Ser. No. 10/374,915, filed Feb. 24, 2003, which is incorporated herein in its entirety.[0001]
FIELD OF THE INVENTION
• The present invention relates generally to tissue removing devices such as biopsy devices and the methods of using such devices. More specifically, it is directed to a device and method for accessing and removing pathologically suspect tissue from within a patient's body.[0002]
BACKGROUND OF THE INVENTION
• In diagnosing and treating certain medical conditions, such as potentially cancerous tumors, it is usually desirable to perform a biopsy, in which a specimen of the suspicious tissue is removed for pathological examination and analysis. In many instances, the suspicious tissue is located in a subcutaneous site, such as inside a human breast. To minimize surgical intrusion into the patient's body, it is desirable to be able to insert a small instrument into the patient's body to access the targeted site and to extract the biopsy specimen therefrom.[0003]
• Electrosurgical techniques have been used in a variety of biopsy procedures. In electrosurgery, high frequency electrical energy is typically applied to patient tissue through an active electrode, the electrical circuit being completed by a return electrode in contact with the patent's tissue. Electrical energy flowing through the tissue from the active electrode is effective to ablate tissue near the active electrode, forming an opening in the tissue and so allowing insertion of the instrument into a patient's body. A return electrode may be placed on the exterior of the patient's body or may be incorporated into the device itself. The return electrode is typically attached to the patient at a point remote from where the primary or active electrode contacts the tissue. However, in the case of a bipolar electrode for example, the return electrode may be disposed near to the active electrode. An electrosurgical biopsy instrument is disclosed and claimed in U.S. patent application Ser. No. 09/159,467 for “Electrosurgical Biopsy Device and Method,” now U.S. Pat. No. 6,261,241, assigned to the assignee of the present application, and which is hereby incorporated by reference in its entirety.[0004]
• While these electrosurgical biopsy devices have been found to be effective in many instances, they are not suitable for use in conjunction with magnetic resonance imaging.[0005]
SUMMARY OF THE INVENTION
• This invention is directed to biopsy devices and methods for accessing and collecting tissue from a patient utilizing such devices. These devices provide access to a targeted tissue site and provide for the separation and capture of a tissue specimen from supporting tissue at the targeted site.[0006]
• A tissue collection device having features of the invention includes an elongated probe with an outer member having a tissue penetrating distal tip, a tubular portion proximal to the distal tip, an inner lumen extending within the tubular portion and an opened section or aperture in the tubular portion which provides access to tissue at the targeted site. The probe includes an elongated tissue-cutting member which is preferably at least in part cylindrically shaped and which is slidably disposed within the inner lumen of the outer tubular member. The tissue cutting member is provided with at least one tissue cutting surface which is configured to sever tissue extending into the probe through the open section or aperture of the outer member. The cutting edge on the tissue cutting member may be configured to rotationally and/or longitudinally move to cut a tissue specimen. The cutting movement may include oscillating rotational motion and/or reciprocating longitudinal motion to sever specimen tissue from supporting tissue at the targeted site. The cutting surfaces or edges are radially spaced from a longitudinal axis of the tissue collection device and are generally longitudinally oriented over a length thereof, preferably at an angle in the cutting direction (hereinafter the cutting angle) of less than 90° from the longitudinal axis or from a longitudinally oriented edge of the tissue receiving aperture of the outer tubular member. The cutting edge takes the general curvature of the cylindrical body forming the cutting member.[0007]
• In one embodiment of the invention, the cutting member has an inner lumen preferably extending to the proximal end thereof for tissue specimen removal. Mechanical withdrawal of the tissue specimen may be employed or the proximal end of the cutting member may be configured to be in fluid communication with a vacuum source to aspirate the severed tissue specimen through the inner lumen of the cutting member to a tissue collection station. A higher fluid pressure may be maintained in the inner lumen of the cutting member distal to the tissue specimen to aid in transporting the specimen proximally through the inner lumen. In this manner, the mechanical withdrawal and/or the vacuum on the proximal end of the specimen and a higher pressure on the distal end of the specimen cn move the specimen through the inner lumen of the cutting member to a tissue collection station.[0008]
• In at least one embodiment, the probe of the tissue collection device is secured, preferably releasably secured, to a drive housing provided with at least one drive unit. The tissue cutting member is operatively connected to the at least one drive unit to provide the desired cutting motion. The proximal end of the outer cannula is releasably secured to the drive housing so that the orientation of the outer cannula with respect to the housing can be selected before the probe is inserted into the patient.[0009]
• The probe may be provided with a tubular tissue accessing cannula which is concentrically disposed between the outer tubular member and the tissue cutting member and a distal portion of the accessing cannula is provided with a tissue accessing aperture. The tissue accessing cannula is connected by its proximal end to a drive unit within the housing to rotate the cannula to adjust the orientation of the tissue receiving aperture about the longitudinal axis of the accessing cannula. A proximal extremity of the cutting member is connected to a second drive unit or units to effect the rotation and any longitudinal motion desired for cutting the tissue specimen[0010]
• A method of cutting and collecting a tissue specimen with a tissue collection device embodying features of the invention includes advancing such a device at least partially into tissue at a desired site within the patient's body with the tissue penetrating distal tip of the outer cannula disposed distal to the tissue to be separated from the target site. The inner lumen of the accessing cannula or the interior of the outer tubular member is exposed to tissue through the accessing aperture and the tissue is drawn into the accessing cannula by applying a vacuum to the inner lumen. A cutting member within the probe of the biopsy device may then be moved to cut a tissue specimen from supporting tissue at the target site by rotational and/or longitudinal motions which preferably includes oscillating rotational movement and/or reciprocating longitudinal movement. Vacuum may be applied to the inner lumen of the cutting member, to pull or aspirate the tissue sample proximally. In addition, or alternatively, a higher fluid pressure may be maintained in a distal portion of the inner lumen distal to the specimen to push the tissue specimen proximally or the specimen may be mechanically withdrawn. Fluid pressure may include pressure from a liquid delivered into the interior of the device, such as a physiological saline solution, and may include a gas, such as pressurized carbon dioxide, nitrogen or air, delivered into the interior of the device. Access to ambient air can also maintain a sufficiently high pressure differential to move the specimen through the inner lumen of the cutting member. Anesthetic may be injected to the target site through the outer cannula or the inner lumen of the cutting member. Upon removal from the patient, the tissue specimen may then be subjected to pathological examination. After acquisition of a tissue specimen or specimens, the biopsy device may be withdrawn from the patient.[0011]
• The outer tubular member of the probe provides the support for the probe to enable precise location of the accessing port to the desired location at the target site with its longitudinal orientation being preset before the device is introduced into the patient. If an accessing cannula is provided with the biopsy device, the accessing cannula is rotated to further position the tissue accessing aperture to the desired specimen tissue and also to relocate the accessing aperture about or along the longitudinal axis of the device for taking further specimens. The cutting member quickly and cleanly severs the tissue specimen from the supporting tissue to provide a better tissue specimen for pathological examination.[0012]
• These and other advantages of the invention will become more apparent from the following detailed description of the invention and the accompanying exemplary drawings.[0013]
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is an elevational view, partially in section, of an elongated tissue biopsy system having features of the invention.[0014]
• FIG. 2 is a perspective view of the distal portion of the outer member or cannula of the biopsy device shown in the FIG. 1.[0015]
• FIG. 3 is a transverse view, partially in section, of the proximal end of the distal tip of the outer member shown in FIG. 2 taken along the lines[0016]3-3.
• FIG. 4 is a perspective view of the distal portion of the tissue accessing cannula of a biopsy device shown in FIG. 1.[0017]
• FIG. 5 is a transverse cross-sectional view of the tissue accessing cannula shown FIG. 4 taken along the lines[0018]5-5.
• FIG. 6 is a perspective view of the distal portion of the tissue cutting member of the biopsy device shown in FIG. 1.[0019]
• FIG. 7 is a transverse cross-sectional view of the tissue cutting member shown in FIG. 6 taken along the lines[0020]7-7.
• FIG. 8 is a perspective view of the proximal end of the biopsy device illustrating the releasable connection between the proximal end of the probe and the housing.[0021]
• FIGS. 9A and 9B are schematic transverse cross-sectional views of the probe shown in FIG. 1 in open and closed configurations respectively with the aperture of the tissue accessing device opening to the left.[0022]
• FIGS. 10A and 10B are schematic transverse cross-sectional views of the probe shown in FIG. 1 in open and closed configurations respectively with the aperture of the tissue accessing device opening upwardly.[0023]
• FIGS. 11A and 11B are schematic transverse cross-sectional views of the probe shown in FIG. 1 in open and closed configurations respectively with the aperture of the tissue accessing device opening to the right.[0024]
• FIGS. 12A and 12B are schematic transverse cross-sectional views of the probe shown in FIG. 1 in open and closed configurations respectively with the aperture of the tissue accessing device opening downwardly.[0025]
• FIG. 13 is a perspective view of the distal portion of an alternative design for the probe embodying features of the invention in a closed condition.[0026]
• FIG. 14 is a top plan view of the tissue cutting member of the probe shown in FIG. 13 with an inclined cutting edge.[0027]
• FIG. 15 is a perspective view of the probe shown in FIG. 13 partially open.[0028]
• FIG. 16 is a perspective view of the probe shown in FIG. 13 with the leading distal cutting edge depicted.[0029]
• FIG. 17 is a perspective view of the probe shown in FIG. 13 further rotated from that shown in FIG. 16.[0030]
• FIG. 18 is a perspective view of the probe shown in FIG. 13 with the aperture of the outer member almost closed.[0031]
• FIG. 19 is a perspective view of the distal portion of a tissue cutting member of a biopsy device embodying features of the invention.[0032]
• FIG. 20 is a perspective view of the cutting member of the biopsy device shown in FIG. 19 slidably disposed within an outer cannula of the biopsy device.[0033]
• FIGS. 21A, 21B and[0034]21C are schematic transverse cross-sectional views taken along the lines21-21 shown in FIG. 20 depicting the reciprocating motion of the cutting member.
• FIG. 22 is a plan view of the tissue receiving aperture in the distal portion of the device illustrated in FIG. 20 to further illustrate the reciprocating rotational and longitudinal motion of the cutting member shown in FIG. 20.[0035]
DETAILED DESCRIPTION OF THE INVENTION
• FIGS.[0036]1-7 illustrate asystem10 which includes abiopsy device11 embodying features of the invention. Thebiopsy device11 generally includes an elongated shaft or probe12 having an outer tubular member orcannula13 with atissue penetrating tip14 on the distal end thereof and an opentissue accessing region15, atissue accessing cannula16 and a tissue-cuttingmember17 with atissue cutting edge18 which is preferably at an angle θ with respect to thelongitudinal axis19. The proximal end of the outertubular member13 is releasably secured to adrive housing20 to provide a plurality of discrete orientations to theouter member13. Thehousing20 is provided with a drive unit (not shown) configured to provide motion to thetissue accessing cannula16 and thetissue cutting member17. A tissuespecimen collection station21 is connected in a fluid flow relationship with thetissue cutting member17 throughconduit22 and is connected to a vacuum source (not shown) throughconduit23.
• As shown in more detail in FIG. 2 the[0037]outer member13 has an elongatedtubular body24 with aninner lumen25 which is configured to receive and support the accessingcannula15. The distal end ofinner lumen25 opens to the tissue accessing space between the distal end of thetubular body24 and the proximal end oftissue penetrating tip14. A connecting strut orwall portion26 extends between the tissue penetratingdistal tip14 and thetubular body24 of theouter member13. As shown in FIG. 3, theproximal end27 of the penetratingtip14 is provided with a firstcircular groove28 which is configured to receive the distal end of the accessingcannula16 as shown in FIGS. 1 and 3 and a secondcircular groove29 which is configured to receive the distal end oftissue cutting member17. The penetratingdistal tip14 may have a variety of tip shapes in addition to the conical shape shown and may have an arcuate RF electrode such as disclosed in U.S. Pat. No. 6,261,241, and U.S. Pat. No. 6,471,700, both assigned to the present assignee and both are incorporated herein in their entirety. The width and length of thestrut26 is sufficient to provide required support to thedistal tip14 and may vary depending upon the strength of the material from which it is made. A stiffening rib may be provided to the underside of the strut for structural stiffness. Multiple struts may be used, provided that a large enough opening is available for tissue access to theaperture27 of the accessingcannula15.
• As best shown in FIGS. 4 and 5, the accessing[0038]cannula15 has atubular body30 which defines at least in part thetissue receiving aperture27. Thetubular body30 has aninner lumen31 which is configured to slidably receive thetissue cutting member17. Theaperture27 is configured to receive tissue for the specimen of suitable size. The arcuate length of the side edges32 and33 forming theaperture27. The accessingcannula16 is configured at its proximal end to be operatively connected to a drive unit (not shown) to rotate thetubular body30 about longitudinal axis34 to provide a desired orientation to theaperture27.
• The[0039]tissue cutting member17, as depicted in FIGS. 6 and 7, is formed oftubular member35 which has aninner lumen36 and which has anarcuate wall portion37 formingside cutting edge18. Thetissue cutting edge18 may be a sharpened edge of thearcuate wall portion37 or it may be a blade (not shown) secured to the edge. Thecutting edge18 should be longer than the length of the aperture to ensure complete severance of the tissue specimen from the supporting tissue at the target site upon rotation of thecutting edge18. Thetissue cutting member17 is rotated to effect tissue cutting by cuttingedge18, but the member may also be provided with reciprocating longitudinal movement in addition to the rotational movement thereof to provide a cleaner tissue cut. Both edges of thearcuate wall portion37 may be sharpened or provided with blades for tissue cutting purposes. Thecutting edge18 is spaced radially from the longitudinal axis of the probe and inclined at an acute cutting angle θ with respect to the longitudinal axis34.
• FIGS. 1 and 8 illustrate the releasable connection between the[0040]outer member13 and thehousing20 to allow for a plurality of discrete orientations of the tissue receiving space of the outer member. As shown, the proximal end of thetubular portion24 ofouter member13 is provided with a plurality of longitudinally extendingupstanding ribs38 spaced about the periphery of thetubular portion24. A corresponding number of recessedpassageways39 are disposed about theopening40 in thedistal face41 ofhousing20 designed to receive theribs38.Arcuate ridges42 are provided between theribs38 to receive tooth43 ofreleasable locking mechanism44 provided in the interior ofhousing20. Themechanism44 for releasably locking the proximal end of theouter member13 may take a variety of configurations. Theparticular mechanism44 shown in FIG. 8 is preferably manually operated by the fingers of the operating physician. Theoperator45 is pivotally connected within thehousing20 at an intermediate location so that downward pressure onbutton46 in the top portion of thehousing20 connected toelongated member47 presses the proximal end ofoperator45 raising the distal end and the tooth43 to release the tooth43 from theridge42 to allow for movement of the proximal end oftubular portion24 ofouter member13 with respect to thehousing20. The distal end of themechanism44 is biased upwardly byspring48 so that when the proximal end of theouter member13 is inserted into opening40 the tooth43 rides up rampingsurface49 on the proximal end of theridge42 and seats and is locked on the front face ofridge42.
• The[0041]drive housing20 and attachedprobe11 allows the entire unit to be disposable. The drive units within the housing control the motion of the accessingcannula16 to orient theaperture27 and the motion of the cuttingmember17 which may be rotation or rotation and longitudinal reciprocation. Other means (not shown) may provide mechanical and electrical power, vacuum, and control to the probe device. Examples of replaceable snap-in type drive units are disclosed in Burbank et al., U.S. patent application Ser. No. 10/179,933, “Apparatus and methods for Accessing a Body Site” hereby incorporated by reference in its entirety. Drive units such as that described in WO 02/069808 (which corresponds to co-pending U.S. application Ser. No. 09/707,022, filed Nov. 6, 2000 and U.S. application Ser. No. 09/864,021, filed May 23, 2001), which are incorporated herein by reference, may be readily modified by those skilled in the art to accommodate the movement of the accessingcannula16 and the cuttingmember17.
• FIGS. 9A and 9B,[0042]10A and10B and11A and11B schematically illustrate the operation of thedevice11 and the rotation of theprobe12 to discrete orientations. This series of sketches depict the sequencing of taking tissue specimens from below or the bottom side of a target site. In FIG. 9A theaperture16 is open to the left with thearcuate wall portion40 in a non cutting position. A vacuum is applied to theinner lumen31 of thetissue cutting member17 and tissue50 (shown in phantom) from the target site is pulled into the interior of the accessingcannula15 through theaperture16. In FIG. 9B thearcuate portion37 oftissue cutting member17 is rotated to sever the aspiratedtissue50 from the supporting tissue at the target site with the cuttingsurface18. The vacuum within theinner lumen31 of thetissue cutting member17 causes the tissue specimen to be drawn through the inner lumen and into thecollection station21 shown in FIG. 1. Positive presssure or even ambient conditions distal to the tissue specimen can facilitate tissue passing through theinner lumen31. The accessingcannula15 is then rotated so that theaperture27 is facing upwardly as shown in FIG. 10A and as shown in FIG. 10B the procedure for cutting the tissue specimen is repeated. In FIGS. 11A and 11B theaperture27 is open to the right and the procedure is again repeated for additional specimens. Other intermediate positions for theaperture27 are possible. When the target site is accessed from the upper portion thereof, theprobe device11 is released from thehousing20 and then is inverted or turned through1800 so that thestrut26 is on top as shown in FIGS. 12A and 12B with theaperture27 open downwardly. Thehousing20, not shown in these drawings, may remain in the same orientation. The same motion for the accessingcannula16 as described above may be used to obtain a similar series of tissue specimens from the top of the target site. If the target site is large enough, the probe may pass through the site and accessing may occur from within the interior of the target site in the same or similar manner as that discussed above for accessing the tissue from the top or bottom of the tissue site.
• FIGS.[0043]13-18 illustrate aprobe60 for a biopsy device embodying features of the invention. Inprobe60 the outer member orcannula61 has atissue receiving aperture62 for receiving tissue from the target site. Theouter member61 has a sharpdistal tip63 shown in phantom which is configured to easily penetrate through tissue to the target site.Tissue cutting member64 is rotatably disposed withinouter member61 and has a proximal end (not shown) operatively connected to one or more drive units within housing (not shown) for imparting cutting motion thereto such as previously described herein. Theinner lumen65 oftissue cutting member64 is configured for fluid communication with a vacuum source (not shown) to urge a tissue specimen through theinner lumen65. As mentioned with the description of the embodiment shown in FIGS.1-7, positive pressure or even ambient conditions will aid in passing the severed tissue through theinner lumen65 oftissue cutting member64. Thetissue cutting member64 has anaperture67 as shown in FIG. 14 defined in part by cuttingedge68 andnon-cutting edge69. The cutting surface is longitudinally oriented at an angle with respect to the longitudinal axis of thetissue cutting member64. The cutting surface oredge68 has a distal leadingcutting edge portion70 and a proximal trailing cutting edge portion71. This tissue cutting member structure provides better application of vacuum to tissue at the target site and as a result provides better control of the tissue cutting. The cutting action for this embodiment is shown in the sequence shown in FIGS. 13 and 15-18. In FIG. 13, theaperture62 of theouter member61 is closed by thearcuate wall portion73 oftissue cutting member64. Thenon-cutting edge69 oftissue cutting member64 first appears at the distal end ofaperture67 as shown in FIG. 15. Application of vacuum begins to pull tissue from the target site into the interior of the tissue cutting member at the distal location. As thetissue cutting member64 rotates (as shown in FIGS.16-18) thenon-cutting edge69 first appears to allow tissue to be pulled into theinner lumen65 of the tissue cutting member and thecutting edge68 of the tissue cutting member follows, cutting off tissue pulled into the interior of the cutting member from the supporting tissue at the target site starting from the leadingcutting edge portion70 to the trailing proximal cutting edge portion71 along the length of theaperture67.
• FIG. 19 illustrates a[0044]tissue cutting member80 which embodies features of the invention and which has an elongated cylindrically shapedbody81 with adistal cutting section82. Thedistal cutting section82 has a beveled, needle-likedistal tip83 with a sharpenedopposed edges84 and85 which facilitate cutting of the tissue specimen when the cuttingmember80 is moved within the outer tubular member or cannula86 (as shown in FIG. 20). Alongitudinal slot87, which preferably tapers to smaller transverse dimension in the proximal direction, is provided in thedistal cutting section82 at the proximal ends of the sharpenededges84 and85 and atransverse slot88 is provided at the proximal end ofslot87 to facilitate slight flaring of thedistal cutting section82 as shown byline89. The outward bias of the sharpenededges84 and85 ensures that these edges engage thelongitudinal edges90 and91 of the accessingaperture92 of theouter cannula86 as shown in FIG. 20 to provide a scissor-like cutting motion for severing a tissue specimen from supporting tissue at the target biopsy site.
• FIGS.[0045]21A-21C and FIG. 22 illustrate the oscillating and longitudinal motions of the cuttingmember80 within theouter cannula86 as the cutting member is advanced distally. FIGS.21A-21C are highly schematic transverse cross-sectional views illustrating the rotational oscillation. In FIG. 21A thebeveled tip83 is centrally positioned within the accessingaperture92. In FIG. 22B the cuttingmember80 has rotated toward thecutting edge90 ofaperture92 with cuttingedge84 of the cuttingmember80 engaging theedge90 in a scissor-like fashion. In FIG. 21C the cutting member has rotated to thecutting edge91 ofaperture92 with thecutting edge85 of the cuttingmember80 engaging thecutting edge91 in a scissor-like fashion. As shown more clearly in FIG. 22, the cuttingmember80 moves longitudinally as it is rotationally oscillated so that the flared cuttingedges84 and85 engage theedges90 and91 of the length of the accessingaperture92 to provide scissor-like, tissue cutting action. The cutting action preferably continues until thebeveled tip83 has completely traversed theaperture92 and the tissue specimen has been completely severed from supporting tissue at the biopsy site. A vacuum may be applied to theinner lumen93 of the cuttingmember80 to aspirate the severed tissue specimen to the proximal end of the biopsy device where the specimen may be removed. Positive pressure or access to ambient conditions may be provided in the distal tip of theouter cannula86 to aid in the specimen transfer through theinner lumen93 of the cuttingmember80. The cutting edges84 and85 have cutting angles θ with respect to cuttingedges90 and91 (which are generally parallel to the longitudinal axis94) of about 20° to about 80°, preferably about 30° to about 75°, over most of the length of the cutting edges84 and85. However. at the proximal and distal ends of the beveled tip, the cutting angle may approach 90°.
• The cutting[0046]member80 is positioned in its most forward position closing offaperture82 when thebiopsy device93 is advanced to the desired biopsy site. The cutting member is then pulled proximally to expose a desired length of theaperture82 which controls the length of the specimen to be severed from the supporting tissue. The cuttingmember80 is then advanced distally with a side-to-side oscillation to sever tissue drawn or otherwise extending into the interior of theouter cannula86. The cuttingmember80 may also be provided with longitudinal reciprocating motion to aid in severing the tissue specimen from the supporting tissue at the biopsy site.
• The elongated shaft or probe of the biopsy device has a length of about 3 to about 15 cm, preferably, about 5 to about 13 cm, and more specifically, about 8 to about 9 cm for breast biopsy use. To assist in properly locating the probe of the device during advancement thereof into a patient's body, (as described below), the distal extremity of the various members may be provided with markers at desirable locations that provide enhanced visualization by eye, by ultrasound, by X-ray, MRI or other imaging or visualization means. Manual palpation may also be employed. An echogenic polymer coating that increases contrast resolution in ultrasound imaging devices (such as ECHOCOAT™ by STS Biopolymers, of Henrietta, N.Y.) is suitable for ultrasonic visualization. Radiopaque markers may be made with, for example, stainless steel, platinum, gold, iridium, tantalum, tungsten, silver, rhodium, nickel, bismuth, other radiopaque metals, alloys and oxides of these metals. In addition, the surfaces of the device in contact with tissue or other components of the device may be provided with a suitable lubricious coating such as a hydrophilic material or a fluoropolymer.[0047]
• The outer member or cannula, the accessing cannula and the tissue cutting member are preferably formed of stainless steel. However, other high strength materials such as MP35N, other cobalt-chromium alloys, NiTi alloys, ceramics, glasses, and high strength polymeric materials or combinations thereof may be suitable.[0048]
• A patient's skin usually must be breached in order to gain access to a body site where a tissue specimen is to be obtained. A scalpel or other surgical instrument may be used to make an initial incision in the skin. After the specimens have been taken, the biopsy device may be removed from the patient. The entire device may be removed; however, in some embodiments, the outer member may remain within a patient's body to aid, for example, in the acquisition of further tissue specimens and in the placement of markers at the site from which a tissue sample was taken. In addition, it will be readily appreciated that other types of instruments may be inserted into the tissue site through the fixed outer cannula or accessing cannula in addition to or in place of the instruments described above.[0049]
• While particular forms of the invention have been illustrated and described herein, it will be apparent that various modifications and improvements can be made to the invention. For example, while the various embodiments of the invention have been described herein in terms of a biopsy device, it should be apparent that the devices and methods of utilizing the device may be employed to remove tissue for purposes other than for biopsy, i.e. for treatment or other diagnoses. Moreover, individual features of embodiments of the invention may be shown in some drawings and not in others, but those skilled in the art will recognize that individual features of one embodiment of the invention can be combined with any or all the features of another embodiment. Accordingly, it is not intended that the invention be limited to the specific embodiments illustrated. It is therefore intended that this invention to be defined by the scope of the appended claims as broadly as the prior art will permit.[0050]
• Terms such a “element”, “member”, “device”, “sections”, “portion”, “section”, “steps” and words of similar import when used herein shall not be construed as invoking the provisions of 35 U.S.C. §112(6) unless the following claims expressly use the terms “means” or “step” followed by a particular function without specific structure or action. All patents and patent applications referred to above are hereby incorporated by reference in their entirety.[0051]

Claims (70)

What is claimed is:

1. A tissue biopsy device for accessing and collecting a tissue specimen from a target site within a patient, comprising:

a. an elongated probe member which has a longitudinal axis, which has a proximal end configured to be secured to a drive, which has an inner lumen extending therein, which has a penetrating distal tip and which has an aperture proximal to the penetrating distal tip configured to receive tissue from the target site; and

b. an elongated tissue cutting member which is disposed within the elongated probe member, which has at least one tissue cutting edge with a longitudinal orientation at an angle with respect to the longitudinal axis less than 90° over a length thereof, which has an inner lumen extending therein, which is configured to be operably connected to at least one drive unit to move the tissue cutting member to cut a tissue specimen from tissue extending into the tissue receiving aperture of the elongated member.

2. The biopsy device ofclaim 1 wherein the probe member includes a rotatable tissue accessing cannula which is slidably disposed concentrically about the tissue cutting member, has a proximal end, has a distal end seated against a proximal surface of the tissue penetrating distal tip, has an inner lumen extending therein, has a tissue receiving side port spaced proximal to the distal end thereof in fluid communication with the inner lumen and disposed in the open section of the outer cannula and is operably secured to a drive unit in the housing to rotate the tissue accessing cannula to adjust the operating location of the tissue receiving side port.

3. The biopsy device ofclaim 2, wherein the cutting edge of the tissue cutting member is defined at least in part by an arcuate wall section of the tissue cutting member.

4. The biopsy device ofclaim 3 wherein the arcuate wall section of the tissue cutting member has a longer arc length than the arc length of the aperture.

5. The biopsy device ofclaim 4 wherein aperture extends through an arc of less than 90°.

6. The biopsy device ofclaim 2, wherein the cutting edge of the tissue cutting member is longer than the aperture of the tissue accessing cannula.

7. The biopsy device ofclaim 1 wherein the inner lumen defined at least in part by the tissue cutting member is configured to access a vacuum source to transport a tissue specimen through the inner lumen thereof to a tissue collector in fluid communication with the inner lumen.

8. The biopsy device ofclaim 2, wherein the tissue cutting member is configured for rotational movement about a longitudinal axis.

9. The biopsy device ofclaim 8, wherein the tissue cutting member is also configured for reciprocating longitudinal movement.

10. The biopsy device ofclaim 9, wherein the tissue cutting member is configured for reciprocating longitudinal movement of between about 0.01 inch and about 0.2 inch (0.25-5.1 mm).

11. The biopsy device ofclaim 3, wherein the arcuate wall section of the tissue cutting member has longitudinally oriented cutting edges.

12. The biopsy device ofclaim 11 wherein the longitudinally oriented cutting edges of the tissue cutting member has a leading distal cutting edge portion and a trailing proximal cutting edge portion.

13. The biopsy device ofclaim 11 wherein the tissue cutting member has a non-cutting edge which extends parallel with the cutting edge.

14. The biopsy device ofclaim 13 wherein the cutting and non-cutting edges of the tissue cutting member define in part a tissue receiving aperture.

15. The biopsy device ofclaim 2, wherein the tissue cutting member is configured for longitudinal movement along a longitudinal axis.

16. The biopsy device ofclaim 15, wherein the tissue cutting member is also configured for oscillating rotational movement.

17. The biopsy device ofclaim 1 wherein the aperture has at least one longitudinally oriented tissue cutting edge which engages a tissue cutting edge of the tissue cutting member.

18. The biopsy device ofclaim 17 wherein the tissue cutting edge of the tissue cutting member has a tissue cutting angle over a substantial part of its length with respect to the tissue cutting edge of the aperture of about 20° to about 80°.

19. The biopsy device ofclaim 17 wherein the tissue cutting edge of the tissue cutting member has a tissue cutting angle over a substantial part of its length with respect to the tissue cutting edge of the aperture of about 30° to about 75°.

20. The biopsy device ofclaim 17 wherein the tissue cutting member has a beveled needle like distal tip.

21. The biopsy device ofclaim 17 wherein the aperture has a tissue cutting distal edge.

22. A tissue biopsy device for accessing and collecting a tissue specimen from a target site within a patient, comprising:

a. a drive housing which has a plurality of drive units;

b. an outer member which is releasably secured to the drive housing, which has a proximal tubular portion, which has an inner lumen extending within the proximal tubular portion, which has a tissue penetrating distal tip, which has an open section proximal to the tissue penetrating distal tip and which has a supporting strut extending from the penetrating distal tip to the proximal tubular portion;

c. a tissue accessing cannula which is slidably disposed at least in part within the inner lumen of the proximal tubular portion of the outer member, which has an inner lumen extending therein, and which has a tissue receiving aperture spaced proximal to the distal end thereof in fluid communication with the inner lumen of the accessing cannula and which is operably secured to a drive unit in the drive housing to rotate the tissue receiving cannula to adjust the orientation of the tissue receiving aperture; and

d. an elongated tissue cutting member which is formed at least in part of a tubular member, which is slidably disposed within the inner lumen of the tissue accessing cannula, which has a tissue cutting edge, which has an inner lumen extending therein configured to receive a tissue specimen cut by the tissue cutting member, and which is connected to a drive unit to move the tissue cutting member within the inner lumen of the tissue accessing cannula.

23. The biopsy device ofclaim 22, wherein the cutting edge is parallel to a longitudinal axis of the tissue cutting member.

24. The biopsy device ofclaim 22, wherein the cutting edge of the tissue cutting member is defined at least in part by a arcuate wall section thereof.

25. The biopsy device ofclaim 22 wherein the arcuate wall section of the tissue cutting member has a longer arc length than the arc length of the tissue receiving aperture of the tissue accessing cannula.

26. The biopsy device ofclaim 22, wherein the cutting edge of the tissue cutting member is longer than the aperture of the tissue accessing cannula.

27. The biopsy device ofclaim 22 wherein the tissue accessing cannula has a distal end seated against a proximal surface of the tissue penetrating distal tip of the outer member.

28. The biopsy device ofclaim 22 wherein the tissue accessing cannula has a distal end seated in a circular groove in a proximal surface of the tissue penetrating distal tip of the outer member.

29. The biopsy device ofclaim 22 wherein the inner lumen of the tissue cutting member is configured to access a vacuum source to transport a cut tissue specimen through the inner lumen thereof to a tissue collector in fluid communication with the inner lumen of the tissue cutting member.

30. The biopsy device ofclaim 22 wherein the arcuate wall section of the tissue cutting member has an arc length greater than a width of the aperture in the outer member.

31. The biopsy device ofclaim 22, wherein the tissue cutting member is configured for longitudinal movement along a longitudinal axis.

32. The biopsy device ofclaim 22, wherein the tissue cutting member is configured for reciprocal longitudinal movement.

33. The biopsy device ofclaim 22, wherein the tissue cutting member is configured for reciprocal longitudinal movement of between about 0.01 inch and about 0.2 inch.

34. The biopsy device ofclaim 23, wherein the arcuate wall section of the tissue cutting member has longitudinal oriented cutting surface along both edges.

35. The biopsy device ofclaim 22 wherein the aperture has at least one longitudinally oriented tissue cutting edge which engages a tissue cutting edge of the tissue cutting member.

36. The biopsy device ofclaim 35 wherein the tissue cutting edge of the tissue cutting member has a tissue cutting angle over a substantial part of its length with respect to the tissue cutting edge of the aperture of about 20° to about 80°.

37. The biopsy device ofclaim 35 wherein the tissue cutting edge of the tissue cutting member has a tissue cutting angle over a substantial part of its length with respect to the tissue cutting edge of the aperture of about 30° to about 75°.

38. The biopsy device ofclaim 35 wherein the tissue cutting member has a beveled needle like distal tip.

39. The biopsy device ofclaim 22 wherein the aperture has a tissue cutting distal edge.

40. A probe for a tissue biopsy device for accessing and collecting a tissue specimen from a target site within a patient, comprising:

a. an outer member which has a proximal tubular portion configured to be releasably secured to a drive housing, which has an inner lumen extending therein, which has a tissue penetrating distal tip, which has an open section proximal to the penetrating distal tip and a supporting strut extending from the penetrating distal tip to the proximal tubular portion;

b. a tissue accessing cannula which is slidably disposed at least in part within the inner lumen of the tubular portion of the outer member, which has an inner lumen extending therein, and which has a tissue receiving aperture spaced proximal to the distal end thereof in fluid communication with the inner lumen of the accessing cannula and which is configured to be operably secured to a drive unit in a drive housing to rotate the tissue receiving cannula to adjust the orientation of the tissue receiving aperture; and

c. an elongated tissue cutting member which is slidably disposed within the inner lumen of the tissue accessing cannula, which has at least one longitudinal tissue cutting edge, which defines at least in part an inner lumen for receiving tissue cut by the tissue cutting surface, and which is connected to a drive unit to move the tissue cutting member within the inner lumen of the tissue accessing cannula.

41. The probe ofclaim 40 wherein the tissue cutting member is formed at least in part of a tubular member.

42. The probe ofclaim 41 wherein the tissue cutting member is rotatably disposed within the inner lumen of the outer member, has a longitudinal axis, has a longitudinal tissue cutting edge oriented at an angle with respect to the longitudinal axis, has an inner lumen extending therein for receiving tissue cut by the tissue cutting edge and is configured for rotation within the inner lumen of the outer member to cut tissue pulled into the inner lumen of the tissue cutting member.

43. The biopsy device ofclaim 42 wherein the tissue cutting member has a non-cutting surface which defines a tissue receiving aperture along with the tissue cutting edge.

44. The biopsy device ofclaim 43 wherein the non-cutting edge of the tissue cutting member is parallel with the cutting edge thereof.

45. The biopsy device ofclaim 40 wherein the cutting edge of the tissue cutting member has a leading distal cutting edge portion and a trailing proximal cutting edge portion.

46. A method of separating a biopsy tissue specimen from supporting tissue at a target site within a patient's body, comprising:

a. providing a biopsy device having a biopsy probe comprising:

i. an outer member which is releasably secured to a drive housing, which has an inner lumen extending therein, which has a tissue penetrating distal tip secured thereto, which has an open section proximal to the penetrating distal tip and a supporting strut extending from the penetrating distal tip,

ii. a tissue accessing cannula which is slidably disposed at least in part within the inner lumen of the outer member, which has an inner lumen extending therein, and which has a tissue receiving aperture spaced proximal to the distal end thereof in fluid communication with the inner lumen of the accessing cannula and which is operably secured to a drive unit in the drive housing to rotate the tissue receiving cannula to adjust the orientation of the tissue receiving aperture, and

iii. an elongated tissue cutting member which is formed at least in part of a tubular member, which is slidably disposed within the inner lumen of the tissue accessing cannula, which has at least one tissue cutting edge, which has an inner lumen extending therein for receiving a tissue specimen cut by the tissue cutting edge, and which is connected to a drive unit to move the tissue cutting member within the inner lumen of the tissue accessing cannula;

b. advancing the probe at least partially into or adjacent to tissue at the target site;

c. exposing the aperture of the accessing cannula to tissue at the tissue site;

d. applying a vacuum to the inner lumen of the tissue accessing cannula or the tissue cutting member to draw tissue from the tissue site into the inner lumen of the accessing cannula;

e. rotating the tissue cutting member to cut tissue extending into the inner lumen from supporting tissue at the tissue site by the cutting edge of the member; and

f. transporting a tissue specimen through the inner lumen of the tissue cutting member.

47. The method ofclaim 46 wherein the rotational motion of the tissue cutting member is oscillating motion.

48. The method ofclaim 46, wherein the tissue cutting member is moved longitudinally in addition to rotating to cut tissue.

49. The method ofclaim 46, wherein the longitudinal motion of the tissue cutting member is reciprocating motion.

50. The method ofclaim 46, wherein fluid is provided within the inner lumen of the tissue cutting member distal to a tissue specimen that is higher than the vacuum pressure therein to transport the tissue specimen proximally within the inner lumen of the tissue cutting member.

51. A tissue biopsy device for accessing and collecting a tissue specimen from a target site within a patient, comprising:

a. an outer tubular member which has an inner lumen extending therein, which has a penetrating distal tip, and which has a tissue receiving aperture proximal to the penetrating distal tip in fluid communication with the inner lumen and having at least one longitudinally oriented, tissue cutting edge; and

b. an elongated tissue cutting member which is formed at least in part of a tubular member, which is rotatably disposed within the inner lumen of the outer tubular member, which has a longitudinal axis, which has a longitudinal tissue cutting edge oriented at an acute angle with respect to the longitudinal axis, which has an inner lumen extending therein for receiving tissue cut by the tissue cutting edge and which is configured for rotation within the inner lumen of the outer member to cut tissue extending into the inner lumen of the tissue cutting member.

52. A tissue biopsy device for accessing and severing a tissue specimen from supporting tissue at a target site within a patient, comprising:

a. an elongated probe member which has a longitudinal axis, which has an inner lumen extending therein, which has a tissue penetrating distal tip and which has a tissue receiving aperture proximal to the tissue penetrating distal tip and defined at least in part by one longitudinally oriented, tissue cutting edges; and

b. an elongated tissue cutting member which is disposed within the inner lumen of the elongated probe member and configured for cutting movements therein, which has a distal portion with a tissue cutting edge radially spaced from and is at least in part oriented at an acute cutting angle with respect to the at least one tissue cutting edge defining in part the aperture of the probe member and which is configured to be connected to at least one drive unit to move the tissue cutting member rotationally and longitudinally to sever from supporting tissue a tissue specimen tissue extending into the open tissue receiving section of the elongated member.

53. The biopsy device ofclaim 52 wherein the tissue cutting member has an inner lumen extending therein for receiving at least part of a severed tissue specimen.

54. The biopsy device ofclaim 52 wherein the tissue cutting member has a beveled, needle-like distal tip.

55. The biopsy device ofclaim 52 wherein the tissue cutting member has a pair of tissue cutting edges.

56. The biopsy device ofclaim 52 wherein the cutting angle of the cutting edge of the tissue cutting member with respect to the cutting edge of the aperture is about 20° to about 80°.

57. The biopsy device ofclaim 52 wherein the cutting angle of the cutting edge of the tissue cutting member is about 25° to about 75°.

58. The biopsy device ofclaim 54 wherein the distal portion of the tissue cutting member is expanded to ensure that the cutting edges thereof engage the edges of the tissue receiving aperture of the probe member.

59. The biopsy device ofclaim 58 wherein the beveled distal tip of the tissue cutting member has a pair of cutting edges.

60. The biopsy device ofclaim 59 wherein the beveled distal tip of the tissue cutting member has a longitudinally oriented slot which separates the tissue cutting edges of the tissue cutting member.

61. The biopsy device ofclaim 60 wherein the longitudinally oriented slot tapers in the proximal direction to smaller transverse dimensions.

62. The biopsy device ofclaim 60 wherein the distal portion of the tissue cutting member has a transversely oriented slot proximal to the beveled tip.

63. A device for accessing and collecting tissue from a target site within a patient, comprising:

a. an elongated probe member which has a longitudinal axis, which has a proximal end configured to be secured to a drive, which has an inner lumen extending therein, which has a penetrating distal tip and which has an aperture proximal to the penetrating distal tip configured to receive tissue from the target site; and

b. an elongated tissue cutting member which is disposed within the elongated probe member, which has at least one tissue cutting edge with a longitudinal orientation at an angle with respect to the longitudinal axis less than 90° over a length thereof, which has an inner lumen extending therein, which is configured to be operably connected to at least one drive unit to move the tissue cutting member to cut a tissue from tissue extending into the tissue receiving aperture of the elongated member.

64. A device for accessing and collecting tissue from a target site within a patient, comprising:

a. a drive housing which has a plurality of drive units;

b. an outer member which is releasably secured to the drive housing, which has a proximal tubular portion, which has an inner lumen extending within the proximal tubular portion, which has a tissue penetrating distal tip, which has an open section proximal to the tissue penetrating distal tip and which has a supporting strut extending from the penetrating distal tip to the proximal tubular portion;

c. a tissue accessing cannula which is slidably disposed at least in part within the inner lumen of the proximal tubular portion of the outer member, which has an inner lumen extending therein, and which has a tissue receiving aperture spaced proximal to the distal end thereof in fluid communication with the inner lumen of the accessing cannula and which is operably secured to a drive unit in the drive housing to rotate the tissue receiving cannula to adjust the orientation of the tissue receiving aperture; and

d. an elongated tissue cutting member which is formed at least in part of a tubular member, which is slidably disposed within the inner lumen of the tissue accessing cannula, which has a tissue cutting edge, which has an inner lumen extending therein configured to receive tissue cut by the tissue cutting member, and which is connected to a drive unit to move the tissue cutting member within the inner lumen of the tissue accessing cannula.

65. A probe for accessing and collecting tissue from a target site within a patient, comprising:

a. an outer member which has a proximal tubular portion configured to be releasably secured to a drive housing, which has an inner lumen extending therein, which has a tissue penetrating distal tip, which has an open section proximal to the penetrating distal tip and a supporting strut extending from the penetrating distal tip to the proximal tubular portion;

b. a tissue accessing cannula which is slidably disposed at least in part within the inner lumen of the tubular portion of the outer member, which has an inner lumen extending therein, and which has a tissue receiving aperture spaced proximal to the distal end thereof in fluid communication with the inner lumen of the accessing cannula and which is configured to be operably secured to a drive unit in a drive housing to rotate the tissue receiving cannula to adjust the orientation of the tissue receiving aperture; and

c. an elongated tissue cutting member which is slidably disposed within the inner lumen of the tissue accessing cannula, which has at least one longitudinal tissue cutting edge, which defines at least in part an inner lumen for receiving tissue cut by the tissue cutting surface, and which is connected to a drive unit to move the tissue cutting member within the inner lumen of the tissue accessing cannula.

66. A method of separating tissue from supporting tissue at a target site within a patient's body, comprising:

a. providing a tissue removal device having an elongated probe comprising:

i. an outer member which is releasably secured to a drive housing, which has an inner lumen extending therein, which has a tissue penetrating distal tip secured thereto, which has an open section proximal to the penetrating distal tip and a supporting strut extending from the penetrating distal tip,

ii. a tissue accessing cannula which is slidably disposed at least in part within the inner lumen of the outer member, which has an inner lumen extending therein, and which has a tissue receiving aperture spaced proximal to the distal end thereof in fluid communication with the inner lumen of the accessing cannula and which is operably secured to a drive unit in the drive housing to rotate the tissue receiving cannula to adjust the orientation of the tissue receiving aperture, and

iii. an elongated tissue cutting member which is formed at least in part of a tubular member, which is slidably disposed within the inner lumen of the tissue accessing cannula, which has at least one tissue cutting edge, which has an inner lumen extending therein for receiving a tissue specimen cut by the tissue cutting edge, and which is connected to a drive unit to move the tissue cutting member within the inner lumen of the tissue accessing cannula;

b. advancing the probe at least partially into or adjacent to tissue at the target site;

c. exposing the aperture of the accessing cannula to tissue at the tissue site;

d. applying a vacuum to the inner lumen of the tissue accessing cannula or the tissue cutting member to draw tissue from the tissue site into the inner lumen of the accessing cannula; and

e. rotating the tissue cutting member to cut tissue extending into the inner lumen from supporting tissue at the tissue site by the cutting edge of the member.

67. The method ofclaim 66 wherein severed tissue is transported through the inner lumen of the tissue cutting member.

68. The method ofclaim 67 wherein the severed tissue is transported by providing a vacuum within the inner lumen of the cutting member.

69. A device for accessing and collecting tissue from a target site within a patient, comprising:

a. an elongated probe means which has a longitudinal axis, which has a proximal end configured to be secured to a drive, which has an inner lumen extending therein, which has a penetrating means on the distal tip and which has an aperture proximal to the penetrating means on the distal tip configured to receive tissue from the target site; and

b. an elongated tissue cutting means which is disposed within the elongated probe member, which has at least one tissue cutting edge with a longitudinal orientation at an angle with respect to the longitudinal axis less than 90° over a length thereof, which has an inner lumen extending therein, which is configured to be operably connected to at least one drive means to move the tissue cutting means to cut tissue from tissue extending into the tissue receiving aperture of the elongated probe means.

70. A method of separating tissue from supporting tissue at a target site within a patient's body, comprising the steps of:

a. providing a tissue removal means having an elongated probe comprising:

i. an outer member which is releasably secured to a drive housing, which has an inner lumen extending therein, which has a tissue penetrating distal tip secured thereto, which has an open section proximal to the penetrating distal tip and a supporting strut extending from the penetrating distal tip,

ii. a tissue accessing cannula which is slidably disposed at least in part within the inner lumen of the outer member, which has an inner lumen extending therein, and which has a tissue receiving aperture spaced proximal to the distal end thereof in fluid communication with the inner lumen of the accessing cannula and which is operably secured to a drive unit in the drive housing to rotate the tissue receiving cannula to adjust the orientation of the tissue receiving aperture, and

iii. an elongated tissue cutting means which is formed at least in part of a tubular member, which is slidably disposed within the inner lumen of the tissue accessing cannula, which has at least one tissue cutting edge, which has an inner lumen extending therein for receiving a tissue specimen cut by the tissue cutting edge, and which is connected to a drive unit to move the tissue cutting member within the inner lumen of the tissue accessing cannula;

b. the step of advancing the probe at least partially into or adjacent to tissue at the target site;

c. the step of exposing the aperture of the accessing cannula to tissue at the tissue site;

d. the step of applying a vacuum to the inner lumen of the tissue accessing cannula or the tissue cutting member to draw tissue from the tissue site into the inner lumen of the accessing cannula; and

e. the step of rotating the tissue cutting member to cut tissue extending into the inner lumen from supporting tissue at the tissue site by the cutting edge of the member.

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